Provider Demographics
NPI:1629229034
Name:ALD, SHELBY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:
Last Name:ALD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1668 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4830
Mailing Address - Country:US
Mailing Address - Phone:516-287-3359
Mailing Address - Fax:516-977-3266
Practice Address - Street 1:280 MADISON AVE
Practice Address - Street 2:RM 1004
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0808
Practice Address - Country:US
Practice Address - Phone:516-287-3359
Practice Address - Fax:516-977-3266
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0760461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical